My plea to Key and co: Don’t let politics stand in way of dignity for the dying

Senior ministers just want the assisted dying issue to go away. But for people like Rachel Rypma, legislation could not be more important, writes David Seymour.

At first I thought the issue of legalising assisted dying would be a really big deal. One of those major culture war type battles like gay marriage or the Springbok tour or the Auckland Unitary Plan, but now I’m not so sure.

For the opponents it is certainly big. The Select Committee inquiry (a totally separate parliamentary procedure from my bill) has been inundated with submissions to the point where they’ve broken the submission process. Every Catholic priest in New Zealand appears to have been up at the pulpit every weekend saying something like “submit or be damned”. As a result the poor Committee secretariat has spent all of this year processing 22,000 submissions.

However, I don’t think it is a big political change at all. As I’ve gotten used to explaining it to the press, at public debates and meetings, and in many one-on-one conversations, it’s become incredibly simple. You just have to spend some time confronting the options people face at the end of their life.

If you’re reading this on the Spinoff, chances are you’re of a generation where one-in-two will make it to 100. I hope you live a full life, with all your faculties, die in your sleep, and everyone comes to say what a great person you were.

Lecretia Seales. Photo: Lecretia.org

Sadly you may develop some sort of terminal or degenerative illness that will give you an uncomfortable end. Chances are, you will end up well looked after. Palliative care has come a very long way in the last 20 years. There are many things that the wonderful people in hospices and hospitals can do to alleviate suffering.

But despite the protestations of some palliative carers, it doesn’t work for everybody. The High Court acknowledged this in the Lecretia Seales case.

If you’re one of those people with unbearable suffering that cannot easily be alleviated, you still have some choices.

As Dr Gary Cheung at the University of Auckland has told me, there is such a thing as a rational suicide. From reading the coronial records, he estimates that one-in-ten suicides by the elderly are not the depressed, financially distressed, lonely, shunned or those with any other irrational motive for ending one’s life. They are people who understand their condition is going to deteriorate to the point of living hell, and they’d rather go straight to heaven.

For others it doesn’t come to that, because their doctor does it first. According to another University of Auckland study, when GPs were asked to consider the last end-of-life medical decision they were involved with, 4.5% reported prescribing, supplying or administering a drug with the explicit purpose of hastening the end of life. The official position of the NZ Medical Association is that it’s ethical to issue drugs that will end a patient’s life so long as it can be justified on the grounds of pain relief – the so-called “double effect” doctrine.

The final option is simply to suffer to the bitter end, trapped inside a body that lives on but gives no comfort.

These are the options that a small percentage of New Zealanders face. The Supreme Court of Canada has called this trade-off between violent amateur suicide and ongoing suffering the “cruel choice” when it instructed the country’s parliament to legalise assisted dying, which it since has.

At this stage of life, there is no easy option. But once you weigh up the choices people face, the assisted dying issue becomes very simple.

My bill would allow a person who finds themselves within six months of dying from a terminal illness or in an advanced state of decline from a degenerative condition, who has been examined by two doctors and found to be of sound mind, who has been given the space and time to properly consider their options, to decide how and when they die. The outcome is the same as with any of the other choices, but the person at the centre of it is given dignity and control.

This is really not a major change. People get sick, people kill themselves, people are in effect euthanised by their doctors, and people suffer unbearably. My bill would add a dignified choice, where the patient is in charge with dignity under the protection of the law.

The Select Committee inquiry may produce a useful report, but it has no duty to introduce a piece of legislation. And despite the prime minister’s stated support for reform, the government has declined to put my bill up for debate. I don’t demand government support, just that individual MPs have the chance to consider the arguments, hear from their constituents, and ultimately stand up and be counted in a conscience vote.

Unfortunately, much of the government front bench would rather the issue just went away. A conscience vote could represent an electorate seat headache, especially for those opposed to reform. So instead, we wait on the luck of the members’ ballot. Some bills are drawn in a matter of weeks, others sit in the ballot for years on end.

Waiting that long simply isn’t an option for the handful of New Zealanders who need the assisted dying option right now. Last week I met Rachel Rypma. She has Huntington’s disease and she knows that her body is gradually shutting down. Her mind is sharp as a tack, but it takes every ounce of her considerable will to make her voice box push out words. What she made perfectly clear is that she wants to die, her way. For her it could not be a bigger issue. We should give her the choice.

David Seymour is MP for Epsom and leader of the ACT party

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